On Thursday, Costco said it would not begin stocking the abortion medication mifepristone at its more than 500 pharmacies, and conservative groups declared victory following a yearlong pressure campaign. Whether the groups are actually responsible for the wholesale chain’s decision is unclear, but they are framing it as a success and pledging to target retailers that already dispense the drug, which would be a blow to abortion access.
In August 2024, a coalition including far-right law firm Alliance Defending Freedom (ADF) and Inspire Investing — which bills itself as “empowering Christian investors through biblically responsible investing” — sent letters to Costco, Walmart, Kroger, Albertsons and McKesson urging them not to start dispensing mifepristone. The letter to Costco in particular claimed that 6,000 members signed a petition for it not to stock the drug, implying that they might take their business elsewhere.
A coalition including far-right law firm Alliance Defending Freedom and Inspire Investing — which bills itself as “empowering Christian investors through biblically responsible investing” — sent letters to Costco, Walmart, Kroger, Albertsons and McKesson urging them not to start dispensing mifepristone.
In a statement shared with MSNBC, Costco said, “Our position at this time not to sell mifepristone, which has not changed, is based on the lack of demand from our members and other patients, who we understand generally have the drug dispensed by their medical providers.”
The company did not respond to a follow-up question about how it assessed demand for a medication it doesn’t dispense. The potential interest wouldn’t be limited to the chain’s paid members, as nonmembers can fill prescriptions at its pharmacies. It also wouldn’t be cabined to abortions, since mifepristone is used off label to manage miscarriages.
The Washington Post reports that Costco had deliberated for more than a year about whether to offer mifepristone and decided this month not to do so; the paper cites anonymous sources familiar with the conversations.
Still, ADF is taking credit for Costco maintaining the status quo. As the organization’s corporate engagement legal counsel Michael Ross told Bloomberg News, “It’s a very significant win and it’s one we hope to build on this coming year.” Ross added that ADF will turn its focus to CVS and Walgreens, which have been dispensing the drug in states where abortion is legal since early 2024.
It’s a relatively recent development that pharmacies could even stock this drug, which is typically used alongside misoprostol to end an early pregnancy, and conservatives are trying everything they can to shove the genie back in the bottle.
Mifepristone has long been overregulated in the U.S., and for two decades after its approval, the medication had to be dispensed in person by the health care provider who prescribed it. The Covid pandemic led to prescriptions via telemedicine that could be fulfilled by mail-order pharmacies, a change made permanent in late 2021. Then, in January 2023, the Food and Drug Administration said for the first time that brick-and-mortar pharmacies could dispense the drug. CVS and Walgreens swiftly announced plans to stock the medication in states where it was legal.
A month later, 20 Republican attorneys general wrote to CVS and Walgreens and claimed that they might be in violation of a federal law known as the Comstock Act, an anti-obscenity statute passed in 1873. Conservatives have argued that the long-dormant law prohibits sending abortion-causing drugs and devices through the mail or carriers like UPS and FedEx. But the same day as the pharmacy change, the Biden administration’s Department of Justice released legal guidance saying that the Comstock Act can’t be enforced against the shipment of abortion drugs as long as the sender doesn’t know the pills will be used illegally.
ADF’s letters to Costco and others cited the AGs’ claims on Comstock, and lobbed a threat that a change in administration could result in federal prosecutions should the retailers begin stocking mifepristone. “Last year, 20 attorneys general wrote letters advising pharmacies that receiving and dispensing the drug by mail is expressly prohibited by the Comstock Act and many state laws. Violating the Comstock Act alone carries a prison sentence of up to ten years,” the letters read. “The statute of limitations is five years, so the current political leadership at the U.S. Department of Justice cannot provide you cover if the administration changes parties.”
The bigger picture here is that groups like ADF are not satisfied with only conservative-led states passing abortion bans. Their long-term goal is to ban nearly all abortions nationwide under the 14th Amendment, and they’re hoping that courts will aid them along the way to realizing that project by ruling that the Comstock Act is enforceable, or that the FDA was wrong to allow telemedicine prescriptions, or both.
ADF took a case to the Supreme Court in 2024 from physicians seeking to end telemedicine prescriptions, and while the justices said those plaintiffs didn’t have standing to sue, that litigation continues thanks to three state AGs who joined the case. Missouri AG Andrew Bailey, who organized the letter to CVS and Walgreens, is leading that case. Most of the other AGs who signed the pharmacy letter have also signed an amicus brief supporting the lawsuit.
Abortion pills were used in nearly two-thirds of all documented terminations in the U.S. in 2023, and by the end of 2024, about 1 in 4 abortions were provided via telemedicine. Pharmacies stocking abortion pills would make them more accessible than they already are, which is a threat to conservatives’ current ban-by-a-thousand-cuts strategy.
Abortion pills were used in nearly two-thirds of all documented terminations in the U.S. in 2023.
The Costco pressure campaign underscores that GOP lawmakers and groups like ADF know an abortion ban cannot pass Congress, so they are trying to limit access in other ways, namely by targeting pills and working to shutter clinics. Their goal is to make it so people can only get abortion medication by physically traveling to a shrinking number of clinics, with more set to shutter amid fallout from the GOP budget bill that “defunds” large abortion providers like Planned Parenthood.
Planned Parenthood has said that as many as 200 of its clinics could close as a result of the bill, including 75% of its abortion-providing clinics across 12 states. That’s why the organization calls the law a backdoor abortion ban. Making abortion less accessible functions as an effective ban for some women — all before a possible nationwide ban is in place.
This context is why it’s so disappointing that Costco will not dispense mifepristone, a necessary medication for people who need abortions and people experiencing miscarriages — and one that is set to become increasingly difficult to access. ADF added in a press release after the Bloomberg story that it “applaud[s] Costco for doing the right thing by its shareholders and resisting activist calls to sell abortion drugs.” This isn’t about “selling” abortion pills. It’s about pharmacies being willing to dispense medications that people’s doctors have prescribed them.
The Costco statement said it believed that people “generally” have mifepristone dispensed by their medical providers, not pharmacies. While many people do still receive the pill directly from their doctor either in person or by mail, telemedicine prescriptions are increasingly filled by mail-order pharmacies like Honeybee Health, and of course other pharmacies do dispense the drug. Just not Costco.
Later in the ADF release, the group claimed that dispensing abortion pills is a bad business decision. “Retailers like Costco keep their doors open by selling a lifetime of purchases to families, both large and small,” Ross said. “They have nothing to gain and much to lose by becoming abortion dispensaries. Retail pharmacies exist to serve the health and wellness of their customers, but abortion drugs like mifepristone undermine that mission by putting women’s health at risk.”
Data shows that abortion restrictions are not only bad for people’s health, but also bad for the economy. The landmark Turnaway Study found that women denied abortions are four times as likely to live below the federal poverty level than women who got care. And in June, the Institute for Women’s Policy Research (IWPR) estimated that the Dobbs decision has led to $64 billion in economic losses each year in the 16 states that ban or heavily restrict abortion. Nationwide, IWPR estimates that bans and other restrictions keep about 550,000 women out of the labor force annually, which is enough to impact GDP, they say.
Corporations may not care about trying to prevent a nationwide abortion access crisis, but they should care about protecting their profits and shareholder value.
